First, I would like to tell you a little bit about how and why I became a member of the Patient Family Advisory Council.

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1 PFAC HEALTH SEMINAR 2014 Introduction: Good afternoon. My name is Kevin Dow and I am with the Braintree Rehabilitation Hospital. I am a former patient and am the newly appointed co-chair of our PFAC. My presentation today is going to be more of a disscussion versus a power point or slide presentation. First, I would like to tell you a little bit about how and why I became a member of the Patient Family Advisory Council. I was injured in a motorcycle accident in July A car coming in the opposite direction turned left and I hit them head on. I was life flighted to Beth Israel Hospital where they did multiple spinal cord operations leaving me with permanent spinal cord damage at C4 and C5. I went to Braintree Rehab with the ability to barely walk. I spent 7 weeks there where I learned to do everything all over again. But it was the treatment I got and how the hospital staff treated me that mad me feel different. Their PT and OT personnel always made me feel like I was the only patient they had and I could never tell if they were having a bad day. I left in late September, able to walk and except for frozen shoulders able to do almost everything, albeit in a limited capacity, I was able to do before my accident. Knowing my main goal was to golf again, PT actually had me putting on the day I left. I tell you my story so you can see why my patient confidence level at Braintree was extremely high. I wanted to give back to the people and facility that brought me back. When I was recruited to join the PFAC I was more than willing to work with the people who worked with me. What I want to discuss with you today is some of the projects we have done in our Rehab Hospital that may differ from those in an Acute Care hospital. The length of stay in a Rehab can average 2-3 weeks where Acute Care can be 2-3 days.

2 PEER VISITOR The first is a Peer Visitor. This is not a PFAC project but is performed by PFAC members. The purpose is to match a former patient with a current patient with the same type of injury/rehabilitation. Although the patient would have to agree to meet with the Peer Visitor, it is still possible for the patient to be reluctant to talk. The role of the Peer Vistor is to make the patient comfortable with small talk in hopes that the patient will open up. Our main goal is to talk to the patient and let them know what they may expect in terms of rehabilitation, recovery, and how to cope with their current and sometime final outcome. We give them our experiences and hope it helps in their recovery and future plans. WEEKEND VOLUNTEER PROGRAM PFAC members, especially former patients, raised concerns regarding weekends where patients have little to no PT or OT on their schedule. Some patients have limited or no visitors so it can make for a long and mostly boring weekend. We came up with the idea of visiting volunteers for weekends. Our Patient Advocate, who is a member of our PFAC, polled the current patients to determine the feasibility of this project. The patients liked the idea so the next step was to determine what they would be looking to do. Again, we were able to use our Patient Advocate to interact with the patients and when the result came in it was presented to our Hospital administration. It was determined that volunteer positions would be added and they would have to go thru a normal hiring procedure. The weekend visits would occur between 2-4pm on Saturday and Sunday.

3 DISCHARGE DISPOSITION This was a program that our PFAC played a large part in. Patients discharged from BRH would get a follow up call 30 days after their discharge. The important part of this program is to determine if there were any readmissions to a hospital, especially if it pertained to their discharge. They were asked 5 questions: 1) Did you understand the discharge information as it was presented to you? 2) Did you understand your medication as it was prescribed? 3) Did outside services show up as scheduled? 4) Have you seen your PCP since you were discharged? 5) Have you been re-hospitalized since your discharge? (If yes, get all the information on re-hospitalization? All the information was catagorized with the following being reported (use 11/13). Again, the purpose was to determine if re-hospitalization was for a recurring problem. SMOKING CESSATION This is another project that was not PFAC driven but had PFAC participation. It is another case where a rehab hospital can utilize this project because of the length of stay of the patient.

4 The thought process was that if a patient was a smoker and hadn t been smoking since being admitted maybe we could help that patient continue to not smoke after they were discharged. Approaching the patient was a sensitive issue and had to be handled appropriately. If a patient was willing to continue, we would offer to support them. For instance, would they be willing to wear a patch? If the patient was receptive to the idea, the staff would give the patients name to the Pshychology Department to see if there would be a risk problem. The Psychology Dept. would talk to the patient and offer to support the patient in an Outpatient program with follow-up care. This is a continuing program at Braintree. PATIENT FLOW COMMITTEE This committee was another in which our PFAC had participation. I m sure all hospitals share in this type of situation but a rehab hospital has to determine a fit for patients in a long term situation. Our goal was to reduce the number of bed changes once the patient was admitted. Areas of focus were: We had to meet the criteria for admission. For example: Nursing, Medical and Pharmacy Staff s ability to accommodate patient Influx, room availability and preparation, and a viable discharge plan Why the room changes: Some examples are problem patients, Gender issues, infections, or program preference. Pre-Admission process: Time limitations, the referral source expects an answer in 2 hours, meds that are not FDA approved or cannot be obtained, or matching infections. All of this is tieing into the expectations of the patient. Are their expectations to high? Can we meet their expectations? Was there a liason prior to admission?

5 In order to alleviate the Patient Flow issue, it was decided to reopen a fourth unit, which wasn t being utilized, and private rooms were issued. This helped with the room changes of patients due to infections, for instance. The Patient Flow problem was decreased by 55% ADVERTISING Television ads were done from the input of our PFAC and we had a say in the Advertising Agency. The web page was built around the input of our PFAC and also runs story lines of current and former patients who tell their stories of success at Braintree. CLOSING AND 2014 GOALS These are just some of the projects I feel we can accomplish at a Rehabilitation Hospital do to long term patient stays. However, PFAC s must be able to adapt to changes in hospital policies and administrations. Braintree Rehab Hospital was bought out and in January of this year a new company set up new policies. Most of the programs I just talked about have been eliminated or put on hold, for now anyway. One of the reasons for some of the programs being eliminated is that the new owners do not use volunteers in the hospital. I believe our job now, as a PFAC, is to insure patient confidence remain high as the hospital transitions into a new phase. The patients feel the transition thru the staff. One of the positions we no longer have is that of our Patient Advocate. Our new PFAC focus has become that of the Patient Advocate. We are now in the process of looking into how we can replace that position thru other avenues.

6 At Braintree Rehab we are extremly fortunate to have solid support from our CEO, who attends as many meetings as his time allows. We also have that same support from our Case Manager, who serves as the other Co-Chair. Any time we ask for a Department head for clarification on any matter we have a question on, they are there. The Director of Nursing, the Director of Therapy, the Director of Outpatient Therapy, the Quality Director, and more, have all made appearances and have reported what we have asked for. My hope is all hospitals, eventually, will follow suit. OTHER 2014 GOALS Add more PFAC participation on BRH committees. Increase discussion and review on scheduled publically reportable data and Quality Measures specific to BRH. Assist in marketing efforts/advisory role. Re-introduce Dr. Wasson s Healthometer for Patient Confidence. Although rehabilitation hospitals and Acute Care hospital PFAC s may differ in what their agendas may be, we must remember that our main focus HAS to be on the patients. The confidence they have in the care they are getting, the information they are receiving, and their overall outlook they have are extremely important. At a rehab hospital it may be easier if you will, to gage this, again, because of the length of stay. Dr. Wasson s Healthometer would give a more accurate measure from a patient who is in a hospital for a long period of time. I look forward to working with the Braintree PFAC as their co-chair and with all the hospitals to insure that patient confidence continues to grow.

7 I hope this has given some insight to the role a PFAC has in a rehabilitation hospital, at least at Braintree. Thank you.

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